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Practice patterns for deep vein thrombosis prophylaxis in minimal-access surgery.

Richard Beekman¹, Mark Crowther, Forough Farrokhyar

¹Department of Surgery, Hamilton Health Sciences, McMaster University, Hamilton, Ont.

Canadian Journal of Surgery. Journal Canadien De Chirurgie

|June 6, 2006

Summary

Deep vein thrombosis (DVT) prophylaxis practices vary widely among surgeons for minimal-access surgery (MAS). Evidence-based guidelines are needed to standardize DVT prevention in MAS patients.

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Area of Science:

Surgical Practice
Thromboprophylaxis
Minimal-Access Surgery

Background:

Lack of comprehensive evidence-based guidelines for DVT prophylaxis in minimal-access surgery (MAS).
Need for understanding current DVT prophylaxis practices in MAS.

Purpose of the Study:

To establish current practice patterns for DVT prophylaxis among general surgeons in Ontario for MAS procedures.

Main Methods:

Cross-sectional survey of general surgeons in Ontario.
Data collected on DVT prophylaxis for various MAS procedures.

Main Results:

Most surgeons do not provide DVT prophylaxis for minor MAS (e.g., cholecystectomy, hernia repair).
A minority of surgeons withhold DVT prophylaxis for major MAS (e.g., colorectal, splenectomy).

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Significant variation exists in prophylaxis type, approach, and duration; academic surgeons and early-career surgeons are more proactive with heparin.

Conclusions:

Substantial variability in current DVT prophylaxis practices for MAS among general surgeons.
Clinical trials are needed to develop evidence-based guidelines for DVT prophylaxis in MAS.